05-102431 f p Is
City of Federal Way Mechanical Permit #: 05 - 102431 - 00 - ME
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-7000 Fax:(253)835-2609 Inspection request line: (253) 835-3050
Project Name: TOLLEFSEN
Project Address: 2221 S 287TH 0 Parcel Number: 027120 0030
Project Description: Gas to as water heater changeout
Owner Applicant Contractor
Donald W Tollefsen PERMIT GROUP,THE*LINDA THORNQUIS WASHINGTON ENERGY SERVICES CO
2221 S 287TH PL PO BOX 2034 2800 THORNDYKE AVE W
FEDERAL WAY WA 98003-3300 KIRKLAND WA 98083 SEATTLE WA 98199
(206)282-4700
Mechanical Valuation 650 Over the Counter Permit Yes
PERMIT EXPIRES November 23,2005.
Permit issued on May 27,2005
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washington and
the City of Federal Way.ri
,/J
Owner or agent: 1t Date: id—7/—
I t , ,
THIS CARD IS TO REMAIN ON-SITE
CITY OF Community Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 05-102431-00-ME
Owner: DONALD W TOLLEFSEN
Address: 2221 S 287TH ST
FEDERAL WAY, WA 98003-3300
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
0 Mechanical Rough-in(4165) ❑ Gas Piping(4125) 0 Final-Mechanical(4065)
Approved Approved to release test Approved
By Date By Date By Date 7.7.454.-..
MAY-2.7.c2005 14:40 FROM: TOid2q8310_190 5
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MAY 24 - 5
The ollo • it •uired to arsnatio 1 - •,• •c,,— •fete a• •Ucattost will siert be aces•tad. Please • nt le:lb. to or •,•-
PROPERTY INFORMATION
2
2411_11 7 NI 1;1
SITE ADDRESS rr��v SUITE/MET I
ASSESSOR'S TAX/PARCEL r 2 1 ( Z a - a Q Q LOT SIZE(sJ)
LEGAL DESCRIPTION(e.g.Aane Estates,Lot 1)
pemd►yw•rete►>~ekeIva Asswini.J •-
PROJPCT INFORMATION
TYPE OF PERMIT a sup m is a PLUMBING kldECSANICAL
O DEMOLITION o ELECTRICAL a ENGINEERING a FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(P wide detailed description of work included on this permit only)
' _
PROJECT NAME(Krone of Business or Owner last Name) YC) /(ei:r C-"t-
PCOPLE fiFORI/IATIUIV
PROPERTY NAME PRItkI1RYiFtONL
OWNER . l(--Ff.2 v) os--3 IP39 -1113
ARINO ADDRESS �� CrY.SLATE,ZIP
2-z_z_ r J Wce_ei C.(J c q' ;Ic 3
CONTRACTOR CONPner NAME APPUGrrt NAME OFFICE PHONE
WRSW1ill i- Sail/ (-r ) Z -rt:)
)AAI NO ADDice Auete) 3TATd, v CELL moos1' � e� �(?9 s ) -
-
Cti oP PCDERAI WAT Eostr EI S
Zo- °3- ro4�23 NUMBER / oN ( i -
CONTRACTOR'S maw• '•N NutraER an aka - L rt
f.vI s S H 1157.1. €7 714x3. — _ ., fEXPIRATION DATE
or
APPLICANT COMPARVNAME .
(T,(.•O� g OPS&�M
.71.e ? ,i - 6ra�rr0 arlie'mtut/_i ( )
MARINO ADDRESS q�_T•�Y�S�-A�.'ZIP
f 0Al . 703 t ... 4.'4g-C WA Van 7 2r)�7e*- 724P'
REIATI NS tPTp Arc NUMBER
0 Architect U Tenant a Agent o Other(Describe) ( I
CONTACT .-.1 HAS PW RY PHONE &SIAIt.ADDRESS
'`�� 1 -�,� MLtr,cl� ern 4 cl • -324,-Fd
LENDS Per'tetra o yolis, .. II"E
��+nJ*r�efi is.;
regutred irprq1.41 value recants SUMO,
MAILING AbBRESS any,snit,ZIP •
DETAILED BUILDING Lr1FORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OP PROPOSED WORK $
SPRINKLERED BUILDING? a YES a so FIRE SUPPREssION SYSTEM PROPOSED/REQUIRED? 0 TEM o NO
WATER SERVICE PROVIDER O LARERAVEN O KIGKLINE o TACOMA a PRIVATE(WELL!
SEWER SERVICE PROVIDER O LAICsnAVEN O KIGHLINE O PRIVATE(SEPTIC)
------
MAY-23:2005 14:41 FROM: TO:12538352609 P.6
•
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE/CARPORT
HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL LXISPOIO MO mROPOSID
`NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ _
FIXTURES
Indicate number of each type of fixture to he installed or relocated as part of this project. Do not Include existing ftxtureS to remain.
MECHANICAL /
Value of Mechanical Work $ (P 5
AIR HANDLING UNITS EVAPORATIVE COOLERS _ GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(c.mmari.l) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES / GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS ler Tub/th.....Combo) SHOW ERS WATER CLOSETS rr.ar,l MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS •
LAVS1e.0 ..m swc l _ VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I.certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I
am authorized by the owner of the above premises to perform,the work for which the permit application is made. I further agree to hold
harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of
such claim),which may be made by any person,including the undersigned,and flied against the City of Federal Way,but only where such claim
arises out of the reliance of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE '�
DATE a10 fi
(Sibnature) (Title)
.
RELATIONSHIP TO P OJECT 0 Owner g oContractor 0 Architect t7 Other
FOR OFFICE USE ONLY
o NEW a ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES a NO
ZONING DESIGNATION CHANGE OF USE? a YES a NO
NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? o YES a NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES D NO
,ac._ r-J-) a
Bulletin#100—March 30,2004 Page 2 of 4 k\I landouts—Rcviscd\l'cnnit Application